Worldwide Medical Optimum Plus

Type of plan
Optimum Plus
Maximum coverage per insured
US$5,000,000 per policy year
Age limit to apply
75
Waiting period
60 days
Coverage outside USA
100% worldwide without restrictions of doctors and hospitals
Coverage inside USA
100% without restrictions of doctors and hospitals
Inpatient Benefits
Standard private hospital room
100%
Special benefit for suite
N/A
Intensive care unit
100%
Adult companion accommodation during a hospitalization
N/A
Prescribed medications while hospitalized
100%
Psychiatric treatments
N/A
Outpatient Benefits
Emergency room
100% applies a US$20 co-payment
Physician and specialist visits
100%
Physician and specialist home visits
N/A
Prescribed medications
Outside the country of residence
• 100% after a hospitalizatión or outpatient surgery
Within country of residence
• US$4,500, a 20% co-insurance applies
Complementary therapy
N/A
Nurse care at home
N/A
Preventive health checkup
No deductible applies
Executive checkup, only for policyholder
• 100%
Hearing aids
N/A
Alzheimer’s disease
N/A
Autism
N/A
Outpatient surgery
100%
Hormone replacement therapy to relieve the symptoms of menopause
N/A
General Benefits
Surgeon and anesthesiologist fees
100%
Diagnostic study services
Laboratory tests, pathology, X-rays, MRI/CT/PET scans
• 100%
Oncology: cancer tests, treatment (chemotherapy and/or radiotherapy) and medication
100%
Dialysis
100%
Prophylactic surgery to reduce the risk of cancer
N/A
Prostheses and medical appliances implanted during surgery
100%
Organ and tissue transplant
Per diagnostic
• US$1,000,000 per lifetime
Benefits for live donors
Included in the organ transplant benefit up to US$1,000,000, no limit specified
Durable medical equipment
N/A
Allergy treatments
N/A
Physical therapy and rehabilitation
100%
Specialized treatments
Coverage for sleep apnea study
• 100% after a 24-month waiting period
Congenital conditions diagnosed before age 18
US$500,000 per lifetime
Congenital conditions diagnosed after age 18
Included in the congenital conditions diagnosed before age 18 up to US$500,000
HIV-AIDS
US$250,000 per lifetime, after a 12-month waiting period
Surgical treatment of symptomatic foot disorders
N/A
Bariatric surgery
100% after a 24-month waiting period
Psychology
N/A
Mental health prescription medication
N/A
Maternity Benefits
Maternity
No deductible, after a 10-month waiting period
Options II & III
• US$20,000 per pregnancy, for normal or c-section
Maternity and birth complications
No deductible, after a 10 month waiting period
Options II & III
• US$1,000,000 per lifetime
Inclusion of the newborn
Options II & III
• Without underwriting if born from a covered maternity as long as the newborn is added to the policy within 90 days of birth
Extraction and storage of umbilical cord blood stem cells
N/A
Fertility treatment
N/A
Neonatal Intensive Care Unit (NICU)
Options II & III
Newborn coverage benefit
• US$50,000 during the first 90 days after birth
Pre-natal and post-natal care
Options II & III
Pre-natal
• Included in the maternity benefit up to US$20,000

Options II & III
Post-natal
• Included in the newborn coverage benefit up to US$50,000
Medical Evacuation Benefits
Emergency transportation by ground ambulance
Outside the country of residence
• US$200,000
Within country of residence
• 100%
Emergency transportation by air ambulance
Included in the emergency transportation by ground ambulance benefit up to US$200,000 outside the country of residence and at 100% within country of residence
Insured’s and companion’s return ticket after an evacuation by air ambulance
N/A
Repatriation of mortal remains
N/A
Other Benefits
Injuries during the training or practice of hazardous hobbies and sports (non-professional)
N/A
Injuries during the training or practice of professional sports
N/A
Emergency dental coverage
100%
Reconstructive surgery after an accident or illness
Not specified
Refractive eye surgery
N/A
Palliative care for terminal cases
N/A
Temporary coverage for accidents while application is being underwritten
N/A
Free extended coverage for eligible dependents after policyholder’s death
3 years if occurs from a covered event
Free coverage for dependents
N/A
Elimination/reduction of deductible for no claims made or not having met the deductible
N/A
Deductible elimination
N/A
Second medical opinion
Included
Prosthetic limbs
N/A
Routine and major dental treatment
N/A
Travel reimbursement for treatment in centers of excellence Latam network
N/A
War and terrorism
N/A
Term life insurance
Life benefit
• US$10,000
Additional benefit for accidental death and dismemberment
• US$10,000
Monthly income, for incapacity due to illness or accident for up to 24 months
• US$1,500 after a 90-day waiting period
Declared pre-existing conditions
Not specified
Catastrophic and chronic illnesses that survive the contracting of the service
N/A
Catastrophic and unusual conditions
N/A
Medical emergency
100% applies a US$20 co-payment
Illness or injury in private aircraft
N/A
Contraceptive treatments
N/A
Patient concierge services
N/A
Travel assistance
Included, no amount specified
Hospital cash benefit
N/A
Optional additional benefits
Evacuation to country of choice, country of residence or home country
N/A
Non-emergency evacuation
N/A
Pre-existing conditions waiting period waiver
N/A